Associated Press

Saturday, October 19, 2002

October 18, 2002
WASHINGTON (AP) --

President Bush embraced the cause and called for legislation: "Americans with mental illness deserve our understanding, and they deserve excellent care," he said. Yet six months later, there's still no agreement and little chance for congressional action this year.

"Even if there was a train to get on, we don't have our bags packed and we're not on the platform," said Andrew Sperling, a lobbyist with the National Alliance for the Mentally Ill.

Still, supporters hold out hope for a last-minute deal when Congress returns for a lame-duck session after Election Day.

"I am very disappointed Congress has not made more progress toward enacting meaningful mental health parity legislation," Sen. Pete Domenici, R-N.M., one of the prime sponsors, said Thursday. "I had hoped that, with the president's backing, it would have been done."

The legislation would bar health plans that serve more than 50 people from putting stricter limits on coverage for mental disorders than they put on other illnesses. Health plans could no longer require higher co-payments or allow fewer doctor visits for mental conditions than they do for physical problems.

The parity legislation is backed by majorities in the House and Senate. In April, Bush bolstered his "compassionate conservative credentials" as he called for action this year.

"Our country must make a commitment: Americans with mental illness ... deserve a health care system that treats their illness with the same urgency as a physical illness," Bush said in New Mexico with Domenici, a longtime parity advocate, at his side.

Business groups argue that the mandate will increase the already rising cost of health insurance and might force some employers to drop coverage altogether. Republican leaders in the House agree and remain opposed to the bill.

Despite the president's call, serious talks with House GOP leaders never got off the ground, a Republican leadership aide said Thursday. He said there's no chance that legislation expanding mental health parity will pass this year, saying "health care costs are just too high."

The nonpartisan Congressional Budget Office estimates that the bill would increase the cost of insurance by about 1 percent.

Congress approved a limited mental health parity law in 1996. It barred health plans that offer coverage for mental health from setting lower annual and lifetime spending limits for mental treatments than they set for other ailments. The law exempted group plans with fewer than 51 people.

It expired at the end of 2001, was extended and is now set to expire at the end of this year.

Last year, advocates led by Sens. Domenici and Paul Wellstone, D-Minn., set out to expand the law. The Senate added a provision for full parity to a spending bill, but it was removed in negotiations with the House.

Domenici personally lobbied Bush for his support, and in April the president said he would try to broker an agreement. But those talks have not come close to producing a deal.

Asked about trying to reach a deal with House Republicans, Wellstone aide Brian Ahlberg said, "We're not negotiating at all yet because we haven't got a signal that they're willing to do a bill."

Advocates note that many other important issues remain undone: a host of spending bills, prescription drugs for Medicare, welfare, energy and homeland security, to name a few. They still hold out hope that Congress will find a way to push mental health parity when lawmakers return for a lame duck session after Election Day, when the political calculations might be different.

In fact, some wonder if politics might have gotten in the way as well, with Republicans unwilling to give Wellstone, who's in one of the nation's tightest Senate races, a victory on one of his top priorities.

"His is one of the most contentious and close Senate races in the entire country," Sperling said. "That certainly gave pause to some Republicans."

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